This is normally when people go see a doctor to find out what is causing these problems. They start to feel better when they stop using marijuana but can feel bad if they use it again. Cannabinoid hyperemesis syndrome (CHS), or cannabis hyperemesis syndrome, is caused by long-term cannabis (marijuana) use. People who have CHS experience repeated and severe bouts of nausea, vomiting, dehydration and stomach pain. It is important for people with CHS to stop using marijuana because this will resolve their nausea and vomiting.

Management and Treatment

Although this information comes from case reports, doctors can use these criteria to diagnose the condition more quickly. People in the hyperemesis stage will experience intense and persistent nausea and vomiting. https://ecosoberhouse.com/ Many people with CHS go to their doctor or an emergency room (ER) for treatment. However, doctors may find it challenging to diagnose the syndrome because people tend not to report their use of marijuana.

• It is not clear why cannabis appears to suppress emesis under certain circumstances and induces it in others.
• The throwing up can be bad and can cause you to be low on body water.
• The precise mechanism by which hot bathing produces a rapid reduction in the symptoms of CHS is unknown.
• For example, CVS patients usually have important psychological comorbidities including depression and anxiety [64,65].

Drugs & Supplements

Once they are activated, anandamide and 2-AG have different pathways for biosynthesis and subsequent degradation, in that anandamide is metabolized mainly by FAAH while 2-AG is metabolized via monoacylglycerol lipase [30]. Endocannabinoids are present in the CNS and enteric nervous systems and are released locally on demand by neuronal signaling; they are released in small amounts and become rapidly inactivated [28]. The patient’s urine drug screen (UDS) was positive for tetrahydrocannabinol (THC).

Clinical Presentation, work up and differential diagnosis of Cannabinoid Hyperemesis Syndrome

Among 21 patients who did not abstain, all had ongoing symptoms. Cannabinoid hyperemesis syndrome (CHS) is a condition that you might get if you’ve regularly smoked weed or used marijuana in some other form for a long time. CHS causes you to have repeated episodes of vomiting, severe nausea, stomach pain, and dehydration. You’re more likely to get CHS if you use marijuana at least once a week and have been doing so since you were a teenager.

Case Series and Case Studies

These symptoms can be debilitating and may require medical intervention to manage effectively. Hospital admission in and of itself can serve to resolve CHS in that patients abstain from marijuana during the time they are inpatients. Since marijuana resumption will cause CHS to return, patient education is important in order cannabinoid hyperemesis syndrome to prevent recurrence. Marijuana cessation relieves CHS, sometimes in a matter of hours or a couple of days. In a case study of a 26-year-old woman who suffered from CHS for years and had been using marijuana nonmedically for 11 years, symptoms resolved in the relatively long period of 3 weeks of cannabis abstinence [117].

• For each mechanism proposed, reviewers explored the supportive evidence and the study design.
• In the prodromal phase the patient has morning predominance of nausea, usually without emesis.
• The majority of these individuals are less than nineteen years of age [2].
• In this context a comprehensive history along with initial screening tests should be performed to exclude acute conditions and emergencies (e.g pancreatobiliary disease, intestinal obstruction, pregnancy, etc).

While patients benefit from rehydration and other forms of supportive care, the only effective treatment for CHS is marijuana cessation. Conventional antiemetics are not contraindicated but are generally ineffective likely because of the atypical mechanisms behind CHS. Since there are no laboratory or radiographic examinations that can be used to diagnose CHS, CHS should be diagnosed based on symptoms and patient behaviors. In some cases, CHS is a diagnosis of exclusion after other hyperemetic conditions (such as hyperemesis gravidarum, psychogenic vomiting [PV], or CVS) are ruled out. Chronic or excessive use of cannabinoids may also stimulate the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system in addition to disrupting the endocannabinoid system. The endocannabinoid system plays a role in allostasis of the autonomic nervous system following episodes of stress [55].

Cannabinoid Hyperemesis Syndrome Diagnosis

Smoking extra marijuana won’t help your nausea but will make it worse. Serotonin antagonism in the gastrointestinal tract from medications such as ondansetron, dolasetron, and granisetron likewise have varying levels of efficacy. Drugs with an anticholinergic effect may likewise block medullary mediated vomiting, though they may have minimal impact on visceral stimulation, including the crippling abdominal cramping pain that patients with CHS experience. Opioids, while often prescribed for the patient’s debilitating abdominal pain, are not appropriate for CHS, as they may, in fact, worsen nausea and vomiting.

Skin Conditions